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Comorbidities, age and period of diagnosis influence treatment and outcomes in early breast cancer

International Journal of Cancer Jan 04, 2019

Minicozzi P, et al. - Given that a lower survival for breast cancer (BC) has been reported in eastern than northern/central Europe, and in older than younger women, researchers investigated the impact of comorbidities at diagnosis on the selected standard treatments (STs) given, across Europe and over time, as well as on outcomes including survival/relapse using covariate-adjusted models. Participants were 7,581 stage I/IIA cases diagnosed in 9 European countries in 2009–2013. Surgery; breast-conserving surgery plus radiotherapy (BCS + RT); reconstruction after mastectomy; and prompt treatment (≤6 weeks after diagnosis) were 4 STs analyzed. The preferred mode of treatment in most women was surgery: 72% BCS; 24% mastectomy. This inquiry appeared to be the first investigation addressing this topic. Findings revealed that increase in BCS + RT with time was encouraging. Although STs were usually employed among women without comorbidities, non-standard less prompt treatments were frequently opted for elderly patients, irrespective of comorbidities, with increased risk of mortality/relapse. Based on the findings, ST was recommended for all women, particularly the elderly, wherever possible to maximise the benefits of modern evidence-based treatments.
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